Reversible posterior leukoencephalopathy syndrome (RPLS) is a cliniconeuroradiological entity mainly characterized by the rapidly progressive increase in blood pressure, headache, vomiting, conscious disturbance and seizure. Neuroimaging showed symmetrical reversible white matter edema in bilateral cerebral hemispheres, particularly in posterior brain.Clinical symptoms and neuroimaging changes can be recovered completely with timely and correct treatment. The two major hypotheses about the pathogenesis of RPLS-cerebral vasospasm and cerebrovascular hyperperfusion-have been in dispute. At preseut, most researchers still agree that the latter is the main cause of cerebral edema. This article expounds the new viewpoints of its pathogenesis and the above two major hypotheses in recent years from the characterizations of etiology, pathology and imaging of RPLS.

With the development of computing and storage techniques,there are a lot of medical records and clinical data stored.It raises the issue of how to mine knowledge from these records and to promote the development of traditional Chinese medicine (TCM).Several challenging research subjects of Chinese clinical medicine data mining and analysis have been introduced in the framework of disease-symptom-syndrome-formulaeffect,and the corresponding developments have also been reported.The significant meaning of the data mining and analysis to Chinese medicine is discussed.Then,the detailed works and recent achievements of seven subjects are given including:① Analysis of symptoms to obtain the optimal symptom subset for one disease or syndrome.② Symptom-syndrome or disease to obtain models for syndrome differentiation.③ Analysis of syndrome.④Analysis of Core formula as well as drug addition and subtraction.⑤ Formula-symptom-effect.⑥ Computerized symptoms.⑦ TCM knowledge engineering.

Objective To explore the value of blink reflex (BR) and brainstem auditory evoked potential (BAEP) in the diagnosis of multiple sclerosis (MS). Methods Totally 20 normal persons and 32 MS patients were examined with BR and BAEP respectively.Results 32 MS patients were divided into two groups according to the abnormalities localized to the brainstem: the symptomatic group and the asymptomatic group. The abnormal rates of BR in two groups were 85.7% and 50.0% respectively. The abnormal rates of BAEP in the two groups were 71.4% and 44.4% respectively. The abnormal rates of BR in Ⅴand Ⅶ cranial nerves were both 21.9%. The abnormal rates of BR,BAEP,BR and BAEP in finding out lesions of brainstem were 65.6%,56.3% and 75.0% respectively.Conclusions Subclinical lesions in brainstem, Ⅴand Ⅶ cranial nerves were demonstrated by BR. The combined abnormal rate of BR and BAEP was higher than either test alone.

Objective To explore the MRI features of brain and spinal cord in patients with multiple sclerosis(MS).Methods The data of MRI of 110 patients with clinic definite MS were analyzed retrospectively.Results The lesions on brain MRI were usually seen in the white matter surround the ventricle(55.8%),deep frontal lobe white matter(54.7%),deep parietal lobe white matter(44.2%)and brainstem(25.6%).Basal ganglia(23.3%)and thalamus opticus(11.6%)were also affected.The size of the brain lesions was varied,the appearances were punctiform,mottling,patching,ellipse and so on.The lesions of the spinal cord were usually on the cervical cord(75.0%)and thoracic cord(68.8%).There were string lesions which parallel spinal cord long axial and mottled lesions.The spinal cord lesions existed in both white matter and gray matter.10.0% of the patients had spinal cord atrophy or spinal cord swelling.The signal intensity of lesions was equal T1,long T2 or long T1,long T2,which was related with the clinical course.Conclusion Different size and appearance lesions in the white matter of brain and spinal cord are the main MRI features of MS.

Objective To assess the predicting value of homocysteine ( HCY), low density lipoprotein cholesterin (LDL-C) and carotid intima-media thickness (IMT) for women with coronary artery disease (CAD). Methods To choose 115 patients with CAD and 102 patients of non-CAD;Homocysteine, LDL-C and IMT were assayed respectively;comparison and correlation analysis were performed based on genders. Results The rates for hyperhomocysteinemia and High Lipoproteinaemia in female CAD patients are 59. 6% and 75.0%,respectively,while they are 69. 9% and 78.6% for male CAD patients,which are both remarkably higher than 23.0% ,26.7%, 22. 2% and 23.6% in non-CAD patients ( Ps ＜ 0. 05 ). ROC curve shows that the best diagnostic boundary point is 0.953 mm for female IMT and 1. 021 mm for male IMT. At the boundary point,the sensitivity,specificity,positive predictive value and negative predictive value are 83.7% ,91.4% ,95.7% and 63. 8% in female, much higher than 62.9%, 65.3%, 76.2% and 53.3% in male. Conclusion hyperhomocysteinemia, high lipoproteinaemia are the important risk factors for women with coronary artery disease;IMT might be used as the predictor of CAD, which have more advantages for female than for male patients.

0.05).No significant difference was shown among the four groups for the proportions of brainstem involved(P=0.335).Significant differences were found for the proportions of bilateral hemicerebrum and spinal cord involved(P

Objective To investigate the clinical manifestations and possible mechanism of the multiple sclerosis (MS) combined with uveitis Methods Two cases of MS combined with uveitis were clinically observed by electro physiological, brain MRI and oligoclonic band (OB) examinations,the cases were analyzed and subjected to assessment Results Case1, a 56-year-old man had symptoms of one month′s numbness and twenty-day sudden decrease of visual acuity Viusal evoked potential (VEP)showed a postponed latent period of bilateral P100 waves Brain MRI showed multifocal T 2 Wight Image high signs in subcortical white matter of frontal and parietal lobes OB was postive Case 2: a 35-year-old woman, had recurrence of decrease of visual acuity of bilateral both eyes for 12 months and bilateral lower-limbs numbness Latent period of VEP P100 waves and BAEP I-V waves were postponed Brain MRI showed multifocal round-like T 2 Wight Image high signs in white matter of frontal and parietal lobes OB was postive Referring to the essay reported ,MS combined with uveitis was moetly moderate in manifestations Their causes were uncertain It is suggested that MS is not due to auto-antigen but due to S100-? protein derived from star-like cells Conclusion MS combined with uveitis ,unlike other one ,was clinically moderate and the pathological mechanism is unclear It is suggested that autoantigen such as S100-? protein derived from star-like cell results in MS and uveitis, not in MBP

Objective To analyze the relationship between diabetics and the onset, clinical outcomes and prognosis of brainstem infarction, and to evaluate the impact of diabetes on brainstem infarction. Method Compare 172 cases of acute brainstem infarction in patients with or without diabetes.Analyze the associated risk factors of patients with brain-stem infarction in diabetics by multi-variate logistic regression analysis. Compare the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin scale (mRS) Score, pathogenetic condition and the outcome of the two groups in different times. Results The systolic blood pressure ( SBP ), TG, LDL-C, apolipoprotein B ( Apo B ), glutamyl transpeptidase (γ-GT), fibrinogen(Fb), fasting blood glucose (FPG) and glycosylated hemoglobin( HbA1c)in diabetic group were higher than those in non-diabetic group , which was statistically significant ( P ＜ 0. 05 ). From multi-variate logistic regression analysis, γ-GT, Apo B and FPG were the risk predictors of diabetes with brainstem infarction( OR = 1. 017, 4. 667 and 3. 173, respectively), while HDL-C was protective( OR =0. 288). HbA1c was a risk predictor of severity for acute brainstem infarction( OR = 1. 299), while Apo A was beneficial( OR =0. 212). Compared with brain-stem infarction in non-diabetic group, NIHSS score and intensive care therapy of diabetic groups on the admission had no statistically significance, while the NIHSS score on discharge and the outcome at 6 months' of follow-up were statistically significant. Conclusions Diabetes is closely associated with brainstem infarction. Brainstem infarction with diabetes cause more rapid progression, poorer prognosis, higher rates of mortality as well as disability and higher recurrence rate of cerebral infarction.

Objective To investigate the effect of ulinastatin (UTI) on the expression of brainderived neurotrophic factor ( BDNF ) and remyelination in mice with experimental autoimmune encephalomyelitis ( EAE).Methods Twenty-four C57BL/6 mice were randomly divided into UTI group (U),normal saline treated group (S) and normal control group (N,n = 8,respectively).Demyelinations in the spinal cord were observed by solochrome cyanin staining.The expression of BDNF,myelin basic protein (MBP),and 2',3 '-cyclic nucleotide 3'-phosphodiesterase (CNP) in brain tissue of each group were evaluated by Western blot.Results Average clinical scores in group U at the 12,13,14,22,23,31,33,34 and 35 days were 0,0.25,0.38,0.63,0.63,0.40,0.40,0.40 and 0.40 respectively.They were significantly lower than group S at the same time ( U= 16.00,15.00,14.50,7.50,0.00,14.50,14.50,12.00 and 14.50,all P ＜0.05).Solochrome cyanin staining showed that demyelination of spinal cord in group U was also significantly improved than group S.Expressions of BDNF ( 1.96 ± 0.29),MBP (2.67 ± 0.48 ) and CNP ( 1.75 ± 0.20) in group U were all significantly higher than group S ( There were 0.80 ± 0.15,1.36 ± 0.38 and 1.06 ± 0.18 respectively,all P ＜ 0.05).Conclusions UTI has protective effect on EAE.The possible mechanism is that it could promote remyelination,and protect oligodendrocytes and neurons in EAE model by increasing BDNF expression in brain.

Objective To investigate the correlation between diabetes and brainstem infarction. Methods The diagnozed patients with acute cerebral infarction were recruited in the study. Firstly, they were divided into brainstem infarction group and non-brainstem infarction group, and then they were redivided into brainstem infarction with diabetes, brainstem infarction without diabetes, non-brainstem infarction with diabetes and non-brainstem infarction without diabetes groups according to whether they had diabetes or not. Carotid artery intima-media thickness (IMT) and carotid atherosclerosis were detected and identified with Doppler ultrasound; brain stem infarction and its location were identified with diffusion-weighted imaging; basilar artery atherosclerosis was detected with magnetic resonance angiography (MRA). A multivariate logistic regression analysis was used to screen the different risk factors impacting brainstem infarction. Neurological deficit was evaluated with the modified Rankin Scale (mRS)scores. Results A total of 286 patients with acute cerebral infarction were recruited: brain stem infarction in 63, and 34 of them with diabetes; non-brain stem infarction in 223, and 77 of them with diabetes. The proportions of diabetes (54. 0％ vs. 34. 5%, x2 = 7. 816, P = 0. 005),previous cerebral infarction (38. 1％ vs. 24. 2％ ,x2 =4. 771, P =0. 029), basilar artery atherosclerosis (73.0％ vs. 57. 4％,x2 =5. 028, P =0. 025), as wall as the levels of hemoglobin A1C (HbA1c) (7. 30 ± 2. 42％ vs. 6. 46 ± 1.82％, t = - 2. 531, P = 0. 011 ) and apolipoprotein B (ApoB) (0. 97 ± 0. 33 mmol/L vs. 0. 90 ± 0. 34 mmol/L, t =-2. 180, P = 0. 029) in the brainstem infarction group were significantly higher than those in the non-brainstem infarction group. Multivariate logistic regression analysis showed that diabetes (odds ratio [ OR] 2. 150, 95％confidence interval [ CI] 1. 214-3. 808; P =0. 009) and previous cerebral infarction (OR 1. 835, 95％ CI 1.004-3. 352, P = 0. 048) were the independent risk factors for brainstem infarction. There were significant differences in the levels of HbA1c (P ＜ 0. 001 ), fasting blood glucose (FBG) (P ＜0. 001), ApoB (P =0. 007) and high-density lipoprotein cholesterol (P =0. 018) as well as the proportion of basilar artery atherosclerosis (P = 0. 001 ) among the brainstem infarction with diabetes, without diabetes, non-brainstem infarction with diabetes and without diabetes groups. The levels of HbA1c (8. 81 ±2. 36％), FBG (8. 23 ±3. 12 mmol/L andApoB (1.04 ± 0. 41 mmol/L) as well as the proportion of basilar artery atherosclerosis (85. 3％ )were the highest in the brainstem infarction with diabetes group. Conclusions Diabetes is closely associated with brainstem infarction. Diabetes is more likely to result in pontine infarction.